HomeMy WebLinkAboutSUB-CONTRACTOR AGREEMENTPERMIT # 1.1 J O as ISSUE DATE
PLANNING & DEVELOPMENT SE . �_,•E r, ��
Building &Code Compliance DiVi `
DEC 19 2011
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
7
�0-JL C i if � r t AJ � have agreed to be
o (Company Name/Individual Name)
the r C�it= Sub -contractor for &al. ryl S tU b S
(Type of Trade) (Primary Contractor)
For the project located at
g se-'- av-Qit
(Project Street Address or
e AV
Tax ID #)
It is understood that, if there is any change of status regarding our participation with the above mentioned
project, the Building and Code Regulation Division of St. Lucie County will be advised pursuant to the
filing of a Change of Sub -contractor notice.
CONTRACT SIGNATURE (Qualifier)
PRINT NAME
y ctl j' z__
COUNTY CERTIFICATION NUMBER
State of Florida, County of Sa L %) C 1'1 ct
The foregoing instrument was signed before me this 1 day of
who is personally known _or has 1'sa'�pa 9 L
DLANNA MARIE GfVEP1S
as identification MY COM7�41S310N # GG OT'023
EXPIRES: December 16, 2020
Bonded Th.
HypAiic Unden .ce
Signature of Notary Pub
a nor,A d �,y e,n .S
Print Name of Notary Public
Revised 11/16/2016
A"
SUB -CONTRACTOR SIGNATURE (Qualifier)
L0 r-
PRINT NAME
COUNTY CERTIFICATION NUMBER
State of Florida, County of • LC.I t L.
The foregoing instrument was signed before me this ' I day of
zo17 by LQ f i j1\ 1 Cl �nS
who is personally known ALor has produced a
identification.
L 01.0 vu a t C 1 lv-�6Ck Q
Print Name of Notary Public
,. LAURA R. CUBSEDGE
::Commission # GG 022076
�V' oT tiro'` B0fWWTiwTopFai^ 2lnsura a8��•M?019
STAMP